Meeting people where they’re at: Learning about life on the streets

I was asked to do a more in-depth blog to describe our workshops and preparation leading up to this experience. I wasn’t quite sure how to approach this: should I simply narrate the fundraising we did, the readings we did, meeting the people we met, the presentations we watched, and the discussions we had? Or should I tell you about my personal reaction to being involved in this project? Or should I use this platform to share what I think other people should know?

I’ve decided to discuss my personal reaction – what was most striking to me was the extent to which I developed an understanding of the way that our actions and our language play a role in perpetuating homelessness.

In my last post, I mentioned that I am a Health and Society major. This means the major focus of my degree is understanding the reasons why people are sick, healthy, poor or wealthy on a systematic level. This is undoubtedly important – the systems for education, foster care, corrections, health care and emergency relief, along with the job and housing markets, all have significant roles in homelessness. A change at the systems level affects many people and has enormous potential to prevent and even end homelessness. Political change – looking upstream to prevent homelessness and making changes on the population level – is so much more important than charitable/emergency sheltering work done on the individual level.

While work done on the individual level is extremely significant to individuals, it operates best in a supportive environment, and that means policy change. A core tenet of public health (developed by Geoffrey Rose for cardiovascular disease) is that focusing on people who are already sick or at risk of getting sick treats the causes of disease in those people, but not the causes of disease in the population. Moreover, if you fail to treat the causes of disease in the population, treating the individual may not be enough – released from care into a non-supportive environment may cause them to relapse and become sick again. It’s analogous to holding a bucket under a leaky roof – you might prevent some of the water from falling on the floor, but as soon as you capture a few drops, more rush in to take their place. Yes, you need to keep the floor from getting damaged – but you won’t need to keep holding your bucket there if you fix your roof! (although presumably failing to fix your roof won’t mean that the water in your bucket will fall through your roof again…)

Nonetheless, I want to talk about work done on the individual level. In particular, I want to talk about stigma, stereotypes, privilege and “othering.” Why?

  1. Systems-level work, though important, wasn’t something that was new to me in this experience. It’s something I spend a lot of time talking about already and although it’s fascinating it’s sometimes a bit overwhelming too. Taking such a broad perspective can make me feel powerless – such broad, sweeping changes take a lot of political willpower and a lot of time. By contrast, changing stigma and stereotypes is something I can take concrete action on – I may not change the world, but I can start changing the way I and people close to me think about homelessness.
  2. The more I learned about privilege and othering, the more I came to believe that they are the mechanisms that maintain the status quo for our systems. So in a way, they are both systemic and individual factors. I believe that we can’t make effective policy change without considering the impact of privilege and othering – and so in the chicken-and-the-egg question of changing minds or policies, I’m siding with changing minds, to create better policies.

When writing this post, I thought of one of my favourite works of public art. It comes from Montréal. From most perspectives it looks like a bunch of random letters on sticks. But from one specific perspective, the letters all come together to make words:

Great public art in the gay district, Montreal

Photo credit: Robin Zebrowski, flickr

“Au village nous croyons que les differences doivent enricher plutôt que diviser,” translates to “In the village*, we believe that differences should enrich, rather than divide.”

*The “village” referred to here is a neighbourhood in Montréal formerly known as (and sometimes still referred to) as the “Gay Village,” but officially (and more politely) called “the Village.”

I believe when we allow differences to divide us, we make “each other” into “the other.” We begin to think of people as “others” instead of people and to think that we are too different to have anything in common. We might think that others are hostile and threatening, that they are shameful and unworthy of care and compassion or (perhaps worst of all) that they are uninteresting and have nothing to offer us. But in any case, we are sure that they are not us. [This is called “othering.”]

Interestingly, at the same time as we see people that are marginalized as irreconcilably different from us I think we also make assumptions that they are the same as us in terms of the opportunities that they have and the choices that they can make. We might think that people have wound up on the street because of “poor life choices,” like using drugs or turning to prostitution, without considering the context in which a person has made their choices – or if they even had a choice in what happened in their lives. Or we might see a person’s continued experience of mental illness as a failure to want to get better, or a ploy for attention, rather than a failure of the system or a consequence of the strength of the disorder they may be struggling with. This kind of thinking is often a bit like “Well, if I was in their shoes, I would… instead of…” [This is called privilege – it refers to the feeling that the way we live is the way that everyone ought to live and that our status as the dominant group in society is deserved because we have earned it and others have not. It ignores that others might not have had the opportunity to “earn” dominant status or to live like we do – often because the way we live prevents them from doing so.]

Both of these trains of thought are generally false. We fail to realize that other people are the same as us in terms of having hopes and desires, dreams and a need for acceptance – but we also fail to realize that they have not had the same circumstances and experiences as us so the way they express themselves may be different from the way we express ourselves. But even if you know these assumptions are false, it can be really difficult to realize when you are making assumptions or how you can change them.

For example, I think there’s a subtle hint of superiority in statements like “it’s not their fault: they were born into it/have addictions/have a history of abuse/have a mental illness” or “it’s so sad that they get treated that way; they’re all such nice and wonderful people.” These sound like nice sentiments, but they are also patronizing ones. By absolving people who are homeless of responsibility, we may remove blame but we also suggest that these people are somehow doomed to stay homeless unless they are saved by someone who is capable and responsible. It’s true that by pitying people who are homeless and characterizing them as universally nice we adopt a kinder attitude instead of a hostile one – but we also assert that we feel that our lives are better than theirs, that in order to deserve empathy someone must be perfectly nice all the time and then sort of give up as if there’s nothing we can do but talk about how sad we are.

When I first read about “othering” and “privilege,” I dismissed a lot of it as “sociology bunk.” I may be a Health and Society major, but I went into this field for the statistics, the biology and the testable theories. One of the issues with privilege theory is that it posits that if you reject the theory it is because you are privileged: you benefit from the status quo, believe that you deserve everything you have and that others could have what you have if they just tried harder or behaved more like you, and are threatened by challenges to the status quo. This is difficult because it makes the theory of privilege immune to criticism (i.e., untestable and therefore unscientific) because anyone who calls the theory into question is assumed to be blinded by their own privilege and incapable of mounting a valid critique. So my advice to you is to take claims made by sociologists, feminists or other proponents of privilege theory with a grain of salt – but also to give them a fair assessment. Is it possible that these claims are correct? And what does it mean for you if they are?

To help illustrate my point, here is an example of the impact of othering and a suggestion for how we can overcome privilege:

A nurse that worked with SafeWorks (an inner-city health care program where providers actively go into the streets to deliver health care) did a presentation in one of my Medical Science classes. She discussed with us a case in which a man suffered severe frostbite on his toes while staying outside in the Calgary winter. The frostbite was so severe that the tissue in his toes died and the nurses told him that he should get them amputated in a hospital (besides dead toes being kind of disturbing, he was at serious risk for infection). But the man was so upset about the way he’d been treated in hospitals before that he refused. The nurses could have insisted that their medical training meant that they knew what was best for the patient (i.e, asserted their privilege). Instead, they agreed to regularly change the man’s bandages and eventually (WARNING: not for the faint of heart) his toes fell off. Can you imagine watching your own toes die and fall off being a better alternative than going to a hospital? What depth of fear and mistrust would you have to have in order to refuse help? Or what might have lead you to perceive well-intentioned help as harmful?

The reason that the nurses chose to respect the man’s wishes not to have his toes amputated in spite of their medical judgement was that they followed a framework known as health promotion. Health promotion can be summarized as “meeting people where they’re at.” This means talking to people and listening to them and then helping them meet the needs they express – not the ones you identify or the ones you think should be met. This defies othering, which tells us that others have little of value to contribute (i.e., they don’t know what’s good for them) and privilege, which asserts that authority should not be challenged.

An example of health promotion (or harm reduction) in homelessness is the “Housing First” model. In this model, charitable groups and government organizations listen to what people who are homeless identify as their greatest need – housing – and provide housing with little to no strings attached. This runs contrary to the current model, which emphasizes “getting clean” and dealing with addictions, mental illness and job security before getting people into housing. This approach often draws fire from people who claim that people with addictions don’t deserve housing or that people with mental illnesses can’t be trusted to take care of themselves. But evidence shows that this approach is more effective and, moreover, cheaper than forcing people into treatment before granting them housing. It also seems to increase the likelihood of recovery, probably because a stable house is a better environment to recover in than a shelter or the street.

Again, I don’t want to say that we can’t even question housing-first. Solid evidence is important (and it does exist). I also don’t doubt that people who insist on getting clean first have the best interests of people who are homeless and also have an addiction in mind. But I do think these people unknowingly show privilege by assuming that their opinion is more worthwhile than that of the people that they are serving.

So what’s my point? (and where is the systems tie-in?)

My point is this: a lot of assumptions underlie the attitudes we have about homelessness and good portion of them may be completely wrong. We’re not bad people for having these attitudes – most of us are probably ignorant of them – but when we don’t question these attitudes, they are the voice we bring to our editorials, our neighbours, our families and ultimately to our ballot boxes. This means we build whole policies based on erroneous assumptions or based on our interests rather than the interests of the people those policies serve. It’s no wonder that people then conclude that the system is broken.

I’m not saying that everything we believe about homelessness is wrong and that every stereotype is false and should never be believed. But I am saying that I think it would do a lot of good if we questioned how we knew things to be true and if we made an effort to see things from someone else’s point of view. This might sound like a rather banal and/or oversimplified conclusion: be nicer to each other and we will end homelessness. I know it’s not that simple. But it’s an attitude that at present I don’t think is reflected in our public discourse and that means it’s unlikely to be reflected in our policies.

In closing, I realize that I’ve said very little about homelessness and instead gone on a bit of a rant/self-righteous lecture on privilege. I’ve tried very hard to steer away from that (since that’s part of what originally turned me off of the concept of privilege) but after multiple revisions, I still don’t feel that’s come through. This concept – which extends far beyond homelessness – is the biggest “take-away” I’ve had from my experience so far. But it is still something I’m exploring and it is definitely not something I’ve mastered! I also think it’s important to try and present this concept as a theory instead of an attack – we need to meet all people where they’re at when we communicate, and that includes people of privilege! Moreover, most of us are privileged in at least one area of our lives and disadvantaged in at least one area. So it’s worth bearing in mind that almost everyone can see both sides of this coin in some way (and that might be a good place to explore the concept further).

In the coming days I will focus my blogging on my experiences with trying to live out meeting people where they’re at and noticing the assumptions I make. I’ll include a bit more details specific to homelessness that we discussed in our workshops and that come up during the experience. For now, however, it’s time to pack and prepare – the experience starts tomorrow!

This entry was posted in Homelessness at Home, Reading Week 2014, Student Posts. Bookmark the permalink.

1 Response to Meeting people where they’re at: Learning about life on the streets

  1. Judy Lapointe says:

    Excellent post. As someone living in a homeless foundation building I feel you have a better understanding of what’s going on then professionals earning a living at it.

    What I find odd is Housing first is kind of a contradiction – it’s designed to create stability but if you get kicked out as soon as you move in, if you create instability using your concept of stability what’s the point in housing first? This failure to follow through in creating stability is actually increasing homelessness not decreasing it. These non profits don’t exactly tell public the truth while raising funds – example – they are happy to say how many they house but fail to provide how many they’ve evicted. It’s more helpful to learn you evicted 8000 while housing 4000 – exposing complete date helps guide towards improvement. but these non profits like to keep the negative quiet and never follow through on their own mandates.

    Reports are coming out that there is a higher need of mental health services for those homeless, yet it would be cheaper to provide affective mental health for those creating the programs homeless have to survive. Cheaper to help a few then it is to help the thousands affected by the one creating the mental health problems.

    This view of privilege, actually it’s a psychology of always blame the other, never own the problem. Those who get into homelessness industry should own the problem as to how they actually are creating homelessness. When you own the problem you gain power, you can change you much easier then changing others. for example – I’m medically diagnosed “delusional” I disagree with that label but I”ll own the problem. The cure to delusion is to influence a population to hold my delusion, after all a delusion is just the ability to see what others don’t see – it’s an opposing view point. If a majority holds the same delusion as me – who is pointing a finger at me? This approach helps guide my direction in life – first thing – improve communication skills, keep calm while talking. I can’t blame those who created my homelessness – hell I supported everything that caused me to become homeless. I supported a justice system until I learned it only supports a criminal mind – now there is no way I would support it. I supported our medical system, now I’ve learned our medical system is dysfunctional and can’t cure or create good health but rather encourages poor lifestyles. how can I blame all of society for creating my homelessness when I was doing the exact same thing until it affected me.

    My one guidance I would recommend – don’t be saying you aren’t changing the world. You make zero changes unless you do change the world. We live with limited beliefs – you can’t change city hall, yet it’s only created because we as humans can make change – we change things all the time. You can’t change the world – why not? What’s stopping you from changing the world? You can’t create world peace yet raise money saying the words yet at the same time saying “it’s impossible”. Focus on doing the impossible, an unlimited mind can create the impossible a limited mind can’t do shit. since we are not creating major changes we can conclude we are using very limited minds. World Peace, changing the world just needs a business plan. It’s not as hard as you think. Takes one person to influence another, then two influence 4 and so on. I’m still working on my communication skills, working on me first knowing it will attract another like mind.

    much love to you

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